Highlights in child mental health research: August 2022

Highlights

• This study used longitudinal population data to assess the relationship between parental mental disorders and early childhood developmental vulnerability.
• The authors found that as parent mental disorder comorbidities increased, their children were at increased risk of experiencing developmental vulnerabilities.
• Children who have a parent with three or more mental disorders were two to three times more likely to display multiple developmental difficulties than children of parents with no mental disorders.

Key findings

• Participants were 66,154 children (mean age 5.6 years) and their parents included in the New South Wales Child Development Study – a longitudinal study of a population cohort of children born in NSW between 2002 and 2004.
• Early childhood developmental vulnerability was assessed at 5 years of age using the Australian Early Development Census (AECD) indices that focused on emotional maturity that reflect emotional and behavioural risk for later mental disorders. The authors then classified the results into four risk types: no risk, mild generalised risk, misconduct risk, pervasive risk.
• Parental mental disorder comorbidity was consistently associated with early childhood developmental vulnerability in their children, with an increasing number of mental disorders increasing the risk that their children will experience developmental vulnerabilities in emotional maturity.
• The associations between parental mental disorder comorbidity and early childhood developmental vulnerability remained consistent when controlling for other potential confounding factors e.g., the sex of the child, socio-economic deprivation, Indigenous status.

Implications

• The number of mental disorders diagnosed in parents increases the likelihood that their children will experience developmental vulnerabilities.
• However, the results make it difficult to determine whether it is the number or the type and severity of mental disorders that are most important in increasing the likelihood of early childhood developmental difficulties.
• Parents who experience mental disorders, especially comorbid mental disorders, should be prioritised for interventions focused on the mental health and psychosocial development of their children, as well as the mental health needs of the affected parent(s).

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Highlights

• This systematic review explored the effectiveness of using physical activity interventions to enhance psychological well-being and reduce psychological ill-being (e.g., anxiety, depression) in children aged 6 to 11 years old from the general population.
• Reviewed studies support the use of physical activity interventions in enhancing the psychological well-being of children in school and community settings.

Key findings

• A total of 23 studies were included in this review and were narratively synthesised and categorised into four domains: quality of life, body image, self-esteem, and psychological ill-being.
• Results highlighted the effectiveness of using both physical activity-only and multicomponent physical activity interventions as a convenient pathway to improving body image and self-esteem in children aged 6 to 11.
• Improvements in quality of life were found in overweight children and those with clinical anxiety, yet more research is needed to determine the impact on the general population.
• Despite the positive effect on psychological well-being, evidence for a reduction in the frequency and severity of symptoms associated with psychological ill-being in children is less clear.

Implications

• More research is warranted to understand the impact of physical activity interventions on reducing psychological ill-being in children from the general population.
• Interventions that target both physical activity and psychological wellbeing and ill-being could be used to address concerns around declining rates of physical activity rates and increasing symptoms of psychological ill-being g in children.

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Highlights

• This longitudinal study investigated the impact of COVID-19 on Australian parental and childhood mental health symptoms, particularly obsessive compulsive disorder (OCD) symptoms.
• The findings support existing research that show an increase in mental health symptoms and exacerbation of pre-existing mental health diagnoses during COVID-19, particularly for OCD symptoms.

Key findings

• 141 parents of children ranging in age from 4 to 17 years (mean = 9.21) completed a questionnaire during lockdown in Australia (June–Sept 2020); 35 completed a follow-up questionnaire post-lockdown (Nov 2020–Jan 2021).
• The sample included children without any mental health symptoms (healthy group), a pre-existing OCD diagnosis, and any pre-existing mental health diagnoses.
• All groups experienced increased symptom severity for OCD symptoms during COVID-19. Children with OCD and children with any mental health diagnoses experienced significantly higher washing symptoms associated with OCD.
• Children with OCD reported significant reductions in OCD symptoms post-lockdown.
• Children with any mental health diagnoses were found to be at greater risk of developing OCD symptoms and reported strong preferences for increased support. They did not experience a reduction in OCD symptoms post-lockdown.
• Child anxiety and depression remained stable over the lockdown period for all children. Across all time points, children with any mental health diagnoses reported significantly higher anxiety and depression than both OCD and healthy groups.
• Parents reported that as their worries regarding COVID-19 increased, their own and their child’s mental health symptoms also increased.

Implications

• Online, self-guided interventions with a focus on prevention, based on evidence-based cognitive-behavioural therapy principles, and/or personalised individual therapy through telehealth or phone consultation were favoured by parents of children with mental health concerns.
• Parents reporting high frequency of worry during past pandemics have been shown to increase child anxiety experiences. As adult mental health symptoms increased due to COVID-19, it is important to consider the subsequent impacts on children’s symptoms.

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Highlights

• This meta-synthesis examined the personal reflections of caregivers, children, and adults with autism spectrum disorder (ASD) on mindfulness and acceptance-based therapies, including potential barriers and facilitators to therapy engagement.
• Mindfulness and acceptance-based therapies may assist in managing emotional and behavioural challenges for children and adults with ASD and their caregivers.
• Key facilitators included enhanced self-awareness, better management of negative thoughts, disruptive or problematic behaviours, and the motivating effects of group-based practice.

Key findings

• 10 independent studies were included that targeted caregivers (n= 3), parent-child interventions (n= 6), or adults with ASD (n= 1). Studies were thematically analysed.
• Caregivers highlighted a need to adapt the length and frequency of daily mindfulness practice around busy lifestyles. They also highlighted that training to improve acceptance of themselves and their child enhanced overall family wellbeing.
• Children with ASD focused on therapy benefits and did not identify barriers. This may be because caregivers minimised the barriers for children.
• Children with ASD identified peer support and validation as important, but those with high behavioural needs responded positively to tailored-mindfulness training.
• All groups commented on the importance of mindfulness as a method to enhance self-awareness, self-regulation, and self-care. Peer support provided in group-based therapy was also seen as beneficial.

Implications

• Mindfulness and acceptance-based therapies can enhance an individual’s self-awareness and self- regulation, thereby reducing distress – with benefits extending to families.
• The findings also highlight a need to explore creative and flexible ways to help families engage in regular mindful home practice over time as families considered it difficult to maintain.
• Caregivers who were committed to mindfulness and acceptance-based approaches helped to positively influence their child’s engagement in these therapies, but also benefited personally from having their child attend training.

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